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"Rare Fungal Illness Follows Tornado"

"More than 1,000 people were injured when a severe tornado ripped through Joplin, Missouri, on 22 May 2011, and 158 eventually died. Within a few days of the tornado, several of the injured began to suffer from a fungal infection suspected to be cutaneous necrotizing mucormycosis."

"Doctors scrambled to do what they could, but testing to identify the specific causal fungus lagged, treatment (including surgery and medications) was sometimes ineffective, and five people died. A team of U.S. researchers who investigated the outbreak now report what they say is the largest known cluster of the disease, with 13 identified patients.

The term 'flesh-eating disease' is sometimes used to describe one of the obvious effects of diseases like mucormycosis, but this illness can also seriously affect many other body systems—including the pulmonary, sinus, rhinocerebral, gastrointestinal, cutaneous, and other body systems. In addition, many microbes other than the 10 fungi genera linked to mucormycosis can cause a so-called flesh-eating effect.

The Joplin cases were caused by the fungus Apophysomyces trapeziformis, which is commonly found in soils, decaying vegetation, and water containing organic matter such as leaves and soil. A. trapeziformis and related species thrive in iron-rich, acidic environments and are known to particularly affect individuals with underlying diabetes mellitus, hematological malignancy, iron overload, or acidemia (abnormal blood acidity). These fungi have also been associated with a compromised immune system, malnourishment, transplant receipt, and prolonged corticosteroid use."